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Pediatricians target talks with parents to curb teen gun deaths

Physicians can play a crucial role in helping to decrease the risk of gun-related injuries and deaths among children and adolescents, says the American Academy of Pediatrics.

Gun-related deaths among youths ages 15 to 19 have declined from a peak of 27.8 per 100,000 in 1994 to 11.4 per 100,000 in 2009, says an AAP policy statement published online Oct. 18 in Pediatrics.

But rates are still too high, said O. Marion Burton, MD, AAP immediate past president. “While the rate of firearm-related deaths has declined over the past two decades, it is still one of the top three causes of death in American youths,” he said.

The AAP recommends that physicians discuss firearm safety as part of routine injury-prevention counseling. Such discussions are best done during well-child visits with parents present, Dr. Burton said.

Counseling children about gun safety is not enough, he said. Young children are curious and unlikely to remember safety instructions, while older children can have a tendency to be moody and impulsive. Parents need to consider the safety of guns in their homes, as well as in other homes their children may visit, Dr. Burton said.

“The safest home for children and teens is a home without guns,” he said. “If there are guns in the home, scientific evidence shows the risk of injury or death is greatly decreased when they are stored unloaded and locked, with the ammunition locked in a separate place.”

More than 31,000 people in the U.S. die annually from gunshot wounds, and a large portion of those are young people, said a separate Oct. 25 report from the Johns Hopkins University Bloomberg School of Public Health. The report calls for increased restrictions to help prevent high-risk individuals from owning guns, including raising the legal age for owning a gun from 18 to 21 across the country.

Young adults 18 to 20 are the most likely to commit homicides compared with other age groups, but only five states prohibit this age group from owning handguns, the report said.

“Addressing weaknesses in existing gun laws by expanding prohibitions for criminals, perpetrators of domestic violence, youth and drug abusers, and closing the loopholes that allow prohibited persons to obtain guns can be effective strategies to reduce gun violence,” said Daniel Webster, ScD, MPH, director of the Johns Hopkins Center for Gun Policy and Research and lead author of the report.

The AAP policy statement is a renewal of the academy’s 2000 policy on firearm safety. In its previous policy, the AAP called for a ban on handguns, but the updated statement instead cites support for a ban on semiautomatic assault weapons and strong regulation of handguns.

Although the AAP still has serious concerns about handguns, Dr. Burton said the academy decided to focus on assault weapons after court decisions in 2008 and 2010 struck down handgun bans in Washington and Chicago.

“We are trying to keep with what the law of the land is, but our job is to keep children safe,” he said. “We don’t need to squander young lives to these incidents.”

The revised policy includes new evidence to support the AAP’s position, said M. Denise Dowd, MD, MPH, a lead author of the policy and chief of the section of injury prevention of the division of emergency medicine at Children’s Mercy Hospital in Kansas City, Mo.

In 2011, Youth Risk Behavior Surveillance System data from the Centers for Disease Control and Prevention showed that 5.1% of high school students had carried a gun in the past month. Having a gun accessible in the home has been shown to greatly increase the risk of suicide, even in adolescents with no mental health histories, she said.